Systematic review of emerging technologies in vascularized composite allotransplantation
Systematic review of emerging technologies in vascularized composite allotransplantation
https://www.frontiersin.org/journals/transplantation/articles/10.3389/frtra.2026.1760147/full
Publish Date: 2026-03-09 04:45:00
Source Domain: www.frontiersin.org
Results
Results of the search strategy
Figure 2 provides the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart for the study selection process. Of the 1048 studies screened in PubMed and Embase, 674 studies were excluded at the screening stage due to lack of relevance. 374 studies were then progressed to full-text review, of which 65 studies met eligibility criteria. A manual reference review from included studies revealed 7 additional studies, yielding a total of 72 studies included in the following evidence synthesis. Meta-analysis was not feasible due to heterogeneous reporting of outcomes, variable patient populations, and diverse study methods.
VCA technology PRISMA flow diagram.
The results are presented below as a broad overview of emerging technologies currently under investigation in the field of VCA. Key takeaways are presented from each study, along with an assessment of the potential risk of bias. Results are organized in a combined chronological and conceptual sequence to reflect the progression of technological ideas over the past 20 years. We have concluded the paper with a synthesized discussion that identifies overarching trends in the literature highlighting opportunities for future research to advance the field in clinically impactful directions.
Immunosuppression
Systemic immunosuppression required for VCA carries important risks including infection, metabolic disturbances, and nephrotoxicity. Extensive innovation focuses on developing less toxic or reduced systemic immunosuppression, developing targeted drug delivery systems, and tolerance induction. See Table 1 for an overview of the studies on immunosuppression that will be discussed below.
| Author | Year | Model | Intervention | Results |
|---|---|---|---|---|
| Systemic Immunosuppression | ||||
| Grahammer et al. | 2017 | Clinical case series: 4 hand transplants | Belatacept | Well-tolerated and maintained graft survival in 3 of 4 patients |
| Hui-Chou et al. | 2012 | Rat abdominal wall | Doxorubicin | ↑ 86% graft survival time than… |
